稽留流产患者组织病理学及CXCL9表达水平变化的研究  

Histopathology and changes in CXCL9expression levels in patients with missed miscarriage

作　　者：苏仕月 魏兆莲[1] SU Shiyue;WEI Zhaolian(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院妇产科,安徽合肥230022

出　　处：《中华全科医学》2024年第9期1504-1507,共4页Chinese Journal of General Practice

基　　金：安徽省重点研究与开发计划项目(202104j07020036)。

摘　　要：目的分析稽留流产患者绒毛组织病理及基因表达变化,探讨稽留流产的机制。方法选取安徽医科大学第一附属医院2020年12月—2023年2月人工流产患者参加研究,其中研究组稽留流产35例,对照组35例。通过HE染色和透射电镜观察绒毛组织的病理变化;RNA测序并通过qRT-PCR验证测序结果及CXCL9基因表达变化。结果研究组HE染色合体滋养细胞减少,炎细胞浸润;透视电镜结果显示,细胞滋养层内质网扩张,合胞滋养层线粒体数量减少;Hofbauer细胞增多。RNA测序分析得到上调最显著的基因包括KRT34(FDR=0.008)、MRGPGR(FDR=0.048)、CUZD1(FDR=0.002)、CXCL9(FDR<0.001)、CD72(FDR=0.043)、FGF14(FDR=0.042)、TMEM176A(FDR<0.001)、GAPT(FDR=0.026)。qRT-PCR表明KRT34、MRGPGR、CUZD1、CXCL9、CD72、FGF14、TMEM176A、GAPT基因表达均上调(P<0.05),而研究组CXCL9 mRNA表达(28.66±0.38)和对照组(27.46±0.75)差异有统计学意义(P<0.001)。结论炎性细胞浸润及CXCL9表达上调可能在稽留流产发展中起重要作用。Objective To analyze the histopathological and gene expression changes of villus in patients with missed miscarriage,and explore the mechanism of missed miscarriage.MethodsPatients with induced abortion from December 2020 to February 2023 from the First Affiliated Hospital of Anhui Medical University were selected to participate in the study,including 35 cases of missed abortion in the study group and 35 cases in the control group.The pathological changes of villus tissue were observed by HE staining and transmission electron microscopy,and the sequencing results and CXCL9gene expression changes were verified by RNA sequencing and qRT-PCR.ResultsIn the study group,the number of HE chromatozytial trophoblasts decreased and inflammatory cells infiltrated,and fluoroscopy electron microscopy showed that the endoplasmic reticulum of cytotrophoblasts expanded,the number of mitochondria in syncytial trophoblast decreased and the number of Hofbauer cells increased.The most significant up-regulated genes were KRT34(FDR=0.008),MRGPGR(FDR=0.048),CUZD1(FDR=0.002),CXCL9(FDR<0.001),CD72(FDR=0.043),FGF14(FDR=0.042),TMEM176A(FDR<0.001),and GAPT(FDR=0.026).qRT-PCR showed that the expression of KRT34,MRGPGR,CUZD1,CXCL9,CD72,FGF14,TMEM176Aand GAPTgenes was up-regulated,and the all P<0.05,while the mRNA expression of CXCL9in the study group(28.66±0.38)and the control group(27.46±0.75)were significantly different(P<0.001).ConclusionInflammatory cell infiltration and up-regulation of CXCL9expression may play an important role in the development of missed miscarriage.

关 键 词：稽留流产 早期妊娠 CXCL9基因 

分 类 号：R714.21[医药卫生—妇产科学] R446.8[医药卫生—临床医学]